EP2077754B1 - Switchable joint constraint system - Google Patents

Switchable joint constraint system Download PDF

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Publication number
EP2077754B1
EP2077754B1 EP07826697A EP07826697A EP2077754B1 EP 2077754 B1 EP2077754 B1 EP 2077754B1 EP 07826697 A EP07826697 A EP 07826697A EP 07826697 A EP07826697 A EP 07826697A EP 2077754 B1 EP2077754 B1 EP 2077754B1
Authority
EP
European Patent Office
Prior art keywords
joint constraint
processing unit
motion sensor
sensors
data
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Not-in-force
Application number
EP07826697A
Other languages
German (de)
English (en)
French (fr)
Other versions
EP2077754A2 (en
Inventor
Gerd Lanfermann
Richard D. Willmann
Juergen Te Vrugt
Edwin G. J. M. Bongers
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Philips Intellectual Property and Standards GmbH
Koninklijke Philips NV
Original Assignee
Philips Intellectual Property and Standards GmbH
Koninklijke Philips Electronics NV
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Philips Intellectual Property and Standards GmbH, Koninklijke Philips Electronics NV filed Critical Philips Intellectual Property and Standards GmbH
Priority to EP07826697A priority Critical patent/EP2077754B1/en
Publication of EP2077754A2 publication Critical patent/EP2077754A2/en
Application granted granted Critical
Publication of EP2077754B1 publication Critical patent/EP2077754B1/en
Not-in-force legal-status Critical Current
Anticipated expiration legal-status Critical

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/103—Measuring devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
    • A61B5/1036—Measuring load distribution, e.g. podologic studies
    • A61B5/1038—Measuring plantar pressure during gait
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/45—For evaluating or diagnosing the musculoskeletal system or teeth
    • A61B5/4528—Joints
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/48—Other medical applications
    • A61B5/4851—Prosthesis assessment or monitoring

Definitions

  • the present invention concerns a switchable joint constraint system.
  • Half sided paralysis is one of the most common symptoms of neurological disorders. For example, about 1.8 million people in Western countries suffer from stroke every year. Their rehabilitation should be aimed at restoring the functional use of the affected limb, especially in the activities of daily living.
  • the use of the disabled limb is a promising approach to achieve rehabilitation success. However, people prefer not to use the disabled limb. It is common that they simply forget about it. This leads to a further worsening of the condition of the disabled limb.
  • doctors may put the healthy limb in a plaster cast or restrain it with orthoses. While this "constraint induced therapy" (CIT) is a rather rigorous method, positive results may be obtained.
  • CIT Constraint induced therapy
  • US 2006/0135883 A1 and US 6,344,062 disclose control systems and methods for processing a time series of signals associated with the movement of a device associated with a limb.
  • the time series of motion signals is filtered, such as through an autoregressive filter, and compared to stored data sets representing a limb-motion event and/or phase.
  • a plurality of accelerometers generate the time series of motion signals, based on at least acceleration measurements in three orthogonal directions and/or planes.
  • the acceleration measurements may relate to the movement of an artificial limb, such as a prosthetic or orthotic device.
  • the control system may trigger an actuator to appropriately adjust one or more prosthetic or orthotic joints.
  • this system are directed towards actively enabling the movement of a joint, for example via an actuator, instead of blocking it. Furthermore, this systems are directed towards the facilitation of limb movements, such as walking, without taking into account further situations.
  • a joint constraint system suitable for use in the constraint induced therapy which allows for varying situations where both limbs need to be used while also constraining the movement of the joint when the affected limb should be trained would still be desirable.
  • a switchable joint constraint system which comprises:
  • the individual spatial descriptors in a system according to the present invention can be any parameters that are appropriate to describe the spatial position of e.g. a sensor or the orientation of a limb.
  • such individual spatial descriptors may be Cartesian coordinates (x, y, z), Euler angles or quaternions.
  • the at least one motion sensor in a system according to the present invention may be an inertial sensor.
  • the class of inertial sensors comprises, for example, accelerometers, gyroscopes and magnetometers. Accelerometers may be sensitive to the earth's gravitational field, whereas gyroscopes may be sensitive to the rate of turn.
  • the acceleration sensor may detect acceleration along the x-, y- and z-axis. It is also possible that the acceleration sensor may detect angular acceleration, such as angular acceleration in three substantially orthogonal planes. It is also possible that the motion sensor is a combined sensor which combines, for example, a three-dimensional accelerometer, two two-dimensional gyroscopes and three one-dimensional magnetometers.
  • the sensor or sensors may be located at various positions on the body of the person using the joint constraint system according to the present invention, such as on the arms, legs and/or torso. The sensors may record the movement of the immobilized limb as well as the movement of the impaired limb.
  • the joint constraint which is switchable between a mobile and an immobile state serves to block the motion of a limb by immobilizing a joint. It can be placed removably onto the joint in order, for example, to facilitate hygienical operations, such as washing of the person, using the system according to the present invention. Switching between a mobile state, where the joint may be used, and an immobile state, where the joint cannot be moved and therefore a limb is immobilized, may be undertaken via electrical or electronic commands.
  • the processing unit may comprise signal filters for processing a multitude of simultaneous sensor signals. It may incorporate a microprocessor as a central processing unit.
  • the signals that the processing unit receives from the at least one motion sensor may be raw signals or pre-processed signals. In any case, the processing unit resolves the data from the at least one motion sensor into individual spatial descriptors and time. Furthermore, the processing unit is capable of issuing commands to the joint constraint which cause the joint constraint to adopt a mobile or immobile state.
  • the database is in communication with the processing unit, that is the processing unit is able to read and write data into the database.
  • the database has already stored, that is it already comprises, comparison data.
  • This comparison data has the same structure as the data that the processing unit writes into the database.
  • the comparison data is assigned to at least one predefined situation. This means that a certain variation of the individual spatial descriptors provided via a sensor or several sensors within a given time interval is brought into connection with a certain situation. For example, a variation of the coordinates of the sensors may indicate that the person wearing the system according to the present invention is falling. Another situation could be that the person is resting.
  • the processing unit compares the data from the at least one motion sensor to the data in the database which is assigned to at least one situation. This can be undertaken by comparing the present data that has been written into the database to the stored data. As a result of this comparison the processing unit issues switching commands to the joint constraint, based upon whether a certain situation is met.
  • the processing unit may determine that the person wearing the system is inactive and therefore issue a command to switch the joint constraint into a mobile state.
  • the processing unit determines that the person wearing the system is falling.
  • the joint constraint would also be switched to a mobile state so that the falling person may use the now mobile limb in order to protect himself from injury.
  • the system determines that the person is walking.
  • a constrained arm would be released in order to support a well-balanced gait.
  • the system further comprises a user interface for accessing data from the database.
  • a medical professional may see the amount of activity that the immobilized limb and the affected limb have experienced.
  • the activity may be calculated by integrating three-dimensional data from the sensors over the period of time. Therefore, the medical professional is able to more accurately assess the situation regarding the affected limb.
  • an activity threshold for the patient may be established. This describes the maximum amount of activity that the affected limb may tolerate or the minimum amount of activity that the immobilized limb should still experience. If the upper activity threshold for the affected limb or the lower activity threshold for the impaired limb is reached, the joint constraint is switched to a mobile state so that the working limb may support the affected limb. This prevents overexertion of the affected limb and weakening of the impaired limb.
  • the system further comprises a display unit displaying the status of the system with respect to at least the movement or position of at least one motion sensor.
  • a display unit displaying the status of the system with respect to at least the movement or position of at least one motion sensor.
  • the signals from at least one motion sensor to the processing unit and/or the commands from the processing unit to the switchable joint constraint are transmitted wirelessly.
  • the wireless transmission may, for example, be undertaken via a variety of commercially available wireless transmission technologies like Bluetooth, infrared, WLAN (wireless local area network) and the like. It is also possible to use a proprietary protocol. By eliminating the need for cables the convenience of use for the patient is increased as well as the safety, because the patient cannot stumble over these cables any more.
  • the joint constraint is switched between a mobile and an immobile state by applying an electrical field to an electrorheological fluid or by applying a magnetic field to a magnetorheological fluid.
  • rheological fluids particles align when exposed to the appropriate energy field. When this alignment occurs, the ability of the fluid to flow, or shear, is substantially reduced.
  • One fluid type is responsive to a voltage field (electrorheological fluids) and the other type is responsive to a magnetic field (magnetorheological fluids).
  • these "smart fluids" solidify in the presence of an electrical or magnetic field and re-liquefy when this field is removed.
  • the rheological fluid may be enclosed in a soft garment and be worn around the joint that is to be immobilized in a cuff-like fashion.
  • the use of these fluids is beneficial in that no bulky or moving parts are needed to switch from a mobile to an immobile state, thus allowing for lightweight and unobtrusive joint constraints.
  • the garments allow for a good fit around the patient's joint, thus reducing the danger of chafing.
  • the joint constraint is switched between a mobile and an immobile state by an inflatable cuff.
  • Inflatable cuffs stiffen when air is inflated into chambers around the joint. This provides for a low-cost and low-maintenance joint constraint.
  • the joint constraint is switched between a mobile and an immobile state by locking the joints of an orthosis.
  • Orthoses provide good control over the joint movement as they are tightly attached to the limb.
  • the joints may be either fully locked, fully opened or open only to allow a certain degree of movement.
  • it is beneficial that the joints may be locked at any arbitrary angle.
  • the immobilized limb may be immobilized enough to force the patient to use the impaired limb, while at the same time involuntary stiffening of the immobilized limb due to prolonged non-use is prevented.
  • the system further comprises a release unit which switches the joint constraint to a mobile state after a manual input.
  • a release unit which switches the joint constraint to a mobile state after a manual input.
  • the release unit may take the form of a switch or may be activated via voice control.
  • the release unit may furthermore be configured to switch the joint constraint to a mobile state for a limited time in order to avoid cheating by the patient. Furthermore, the use of the release unit may be recorded in the database.
  • the system further comprises sensors selected from the group comprising electromyographical sensors, skin perspiration sensors, pulse sensors, blood pressure sensors and/or blood oxygen level sensors, and the sensors further provide input to the processing unit.
  • sensors may provide further information regarding the status of the patient. They may especially relate to the stress status of the patient.
  • an electromyographical sensor gives information about the fatigue of a muscle. This is useful in assessing whether the impaired limb is overexerted and should be supported by the other limb.
  • skin perspiration sensors which give information about the electrical conductivity of the skin surface, which changes according to the level of perspiration caused by stress and fatigue.
  • Pulse sensors, blood pressure sensors and/or blood oxygen level sensors may be integrated into one sensor system which can be worn, for instance, on the tip of a finger or can be attached to an ear lobe with a clip. They are useful in providing data related to the circulatory system of the patient.
  • the input from all the aforementioned sensors may be used by the processing unit to more precisely determine whether a predefined situation is encountered or not.
  • a further embodiment concerns a process for handling sensor signals in a system according to the present invention, comprising the steps of:
  • step a) in this process the user may be asked to bring himself into a certain posture. For example, he may be asked to stand upright and let his arms hang freely along the sides of his body. Then the system is able to correlate the sensor output signals with a certain position of the limbs and to subsequently calculate the current position of the limbs.
  • Step b) describes the continuous data gathering by the motion sensors.
  • the motion sensor output signals are assigned to a position and a movement of a sensor. This can be undertaken either in the sensor itself or within the processing unit of the system. In other words, the sensor signals are resolved into individual spatial descriptors and a time dimension. This data which represents the position and movement of at least one sensor is then stored in a database, as mentioned in step d).
  • Step e) comprises the comparison of the position and movement signals, which have been stored in the database, to previously stored data, which is assigned to a certain situation. This can be undertaken by the processing unit of the system. If the variation of the spatial coordinates of one or more sensors over a given amount of time matches the variation of the previously stored data, the system issues a command to switch the joint constraint to an appropriate status. When to switch and which status is to be reached is defined in a decision table within the database, as mentioned in step f). For example, the system may decide that the person is falling and then switch the joint constraint to a mobile state so that the person may use both limbs in order to prevent injury.
  • Fig.1 illustrates a block diagram of the components of the system according to the present invention, showing the interactions between them.
  • the individual components are three motion sensors (1a, 1b, 1c), a display unit (6), a central processing unit (CPU, 3), a joint constraint (2), a database (4) and a user interface (5).
  • the sensors (1a, 1b, 1c) provide input to the CPU (3), which processes the input into data with spatial and time coordinates. This data is stored in the database (4) together with comparison data.
  • the CPU (3) then continually compares the sensor data to the comparison data. Based upon this comparison, that is, when a predefined situation is met, the CPU (3) orders the joint constraint (2) to switch into a mobile state or back into an immobile state.
  • the stored data in the database (4) may be viewed by a user such as a physiotherapist or a physician via a user interface (5). They can review the activity of the limbs with sensors on them and set threshold conditions when the joint constraint is to be activated or not.
  • a display unit (6) is in communication with the CPU (3). It is capable of displaying the status of the system with respect to at least the movement or position of at least one sensor (1). For example, the display unit (6) may show if an impaired limb or immobilized limb is being moved correctly within a target corridor defined by speed of movement or extent of movement. The display unit (6) may also give audio signals to indicate, for example, whether a limb is being used enough or not.
  • Fig. 2 shows a patient wearing motion sensors (1a, 1b, 1c, 1d) and a joint constraint (2).
  • a further motion sensor (1c) is located around the torso of the patient.
  • a fourth motion sensor (1d) is located on the impaired limb.
  • the sensors (1a, 1b, 1c, 1d) and the joint constraint (2) are in wireless contact with the rest of the system.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Veterinary Medicine (AREA)
  • Physics & Mathematics (AREA)
  • Public Health (AREA)
  • Biophysics (AREA)
  • Pathology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Surgery (AREA)
  • General Health & Medical Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Dentistry (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Rheumatology (AREA)
  • Transplantation (AREA)
  • Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)
  • Manipulator (AREA)
  • Prostheses (AREA)
  • Rehabilitation Tools (AREA)
EP07826697A 2006-10-13 2007-10-09 Switchable joint constraint system Not-in-force EP2077754B1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
EP07826697A EP2077754B1 (en) 2006-10-13 2007-10-09 Switchable joint constraint system

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
EP06122243 2006-10-13
PCT/IB2007/054112 WO2008044207A2 (en) 2006-10-13 2007-10-09 Switchable joint constraint system
EP07826697A EP2077754B1 (en) 2006-10-13 2007-10-09 Switchable joint constraint system

Publications (2)

Publication Number Publication Date
EP2077754A2 EP2077754A2 (en) 2009-07-15
EP2077754B1 true EP2077754B1 (en) 2011-03-23

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EP07826697A Not-in-force EP2077754B1 (en) 2006-10-13 2007-10-09 Switchable joint constraint system

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US (1) US20100116277A1 (enExample)
EP (1) EP2077754B1 (enExample)
JP (1) JP2010505578A (enExample)
CN (1) CN101522100B (enExample)
AT (1) ATE502573T1 (enExample)
DE (1) DE602007013437D1 (enExample)
WO (1) WO2008044207A2 (enExample)

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Also Published As

Publication number Publication date
CN101522100A (zh) 2009-09-02
US20100116277A1 (en) 2010-05-13
DE602007013437D1 (enExample) 2011-05-05
EP2077754A2 (en) 2009-07-15
ATE502573T1 (de) 2011-04-15
CN101522100B (zh) 2012-02-08
JP2010505578A (ja) 2010-02-25
WO2008044207A2 (en) 2008-04-17
WO2008044207A3 (en) 2008-06-12

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